No abstract available.
Humans ; Transplants*

When vitrectomy is performed in eyes that have undergone glaucoma surgery, the site of sclerotomy often overlaps with the previous glaucoma operation site. It can lead to serious complications such as postoperative hypotony, leakage, and/or infection. Our technique involves modification of surgeon's position and two sclerotomy sites 45° away from the original position, with an infusion cannula inserted infranasally to avoid damage to the glaucoma drainage implant or filtering bleb. The modified approach was applied to seven eyes with various indications. Vitrectomy was successfully completed, and there were no sclerotomy site complications, leakage, or hypotony in any case. Good intraocular pressure control was maintained throughout the postoperative course in all cases.
Blister* ; Catheters ; Filtering Surgery ; Glaucoma Drainage Implants* ; Glaucoma* ; Humans ; Intraocular Pressure ; Vitrectomy*

Priapism has been classified as primary (idiopathic)and secondary according to etiology. Hemodynamically, it can be separated into two distinct types: low-flow (ischemic) and high flow (non-ischemic). In the latter type, the most common cause is blunt genital trauma, and selective cavernosal artery embolization has been the most effective therapeutic method. Two cases of high-flow arterial priapism are presented. Both cases were post-traumatic and were managed with selective cavernosal artery embolization, with excellent return of premorbid levels of erectile function.
Arteries ; Male ; Penile Erection ; Priapism*

Priapism has been classified as primary (idiopathic)and secondary according to etiology. Hemodynamically, it can be separated into two distinct types: low-flow (ischemic) and high flow (non-ischemic). In the latter type, the most common cause is blunt genital trauma, and selective cavernosal artery embolization has been the most effective therapeutic method. Two cases of high-flow arterial priapism are presented. Both cases were post-traumatic and were managed with selective cavernosal artery embolization, with excellent return of premorbid levels of erectile function.
Arteries ; Male ; Penile Erection ; Priapism*

BACKGROUND: In emergency departments, there are many drunken patients with various emergency medical situations. In these patients, evaluation and management of the medical problems are delayed from time to time because of the uncooperative nature of the patients and because of consciousness and sensory changes. A precise evaluation can only be obtained when the patients become sober. For this purpose, most clinicians start IV fluid loading. This study was carried out to evaluate the effect of IV fluid(normal saline and glucose solution) on the rate of ethanol clearance in such patients. METHODS: Ten volunteers(healthy males in their twenties and with a Michigan alcohol screening test below 4) were enrolled in this study. Alcohol intake was restricted to at least 48 hours before the test and food intake to at least 4 hours. For the test, A predetermined dose of ethanol(1gm/kg) was given to the volunteers. Each volunteer was tested on three consecutive times with 3 or more days interval for alcohol wash out period. On the 1st day, the volunteers received ethanol only per os. On the second day, they received ethanol and a liter of IV normal saline. On the third day, they received ethanol and a liter of IV 10% dextrose solution. Each day, blood was drawn from the antecubital vein to measure the ethanol level at the time of ethanol ingestion and at 0.5, 1, 1.5, 2, 3, 4, 5 and 6 hours after ingestion. The repeated measure ANOVA test was used for the statistical analysis. RESULTS: The difference in the blood ethanol level between the 3 test was F=1.7, p=0.184, and the difference corrected by the time factor was F=0.32, and p=0.985. CONCLUSION: There was no significant difference in the blood ethanol level between the tests. In conclusion, the IV normal saline or glucose solution does not accelerate ethanol clearance in suffering from acute alcohol intoxication.
Consciousness ; Eating ; Emergencies ; Emergency Service, Hospital ; Ethanol ; Glucose* ; Humans ; Male ; Mass Screening ; Michigan ; Time Factors ; Veins ; Volunteers

Pneumopericardium, as a form of barotrauma, refers to the presence of air within the pericardial sac. The causes of pneumopericardium are various. Clinically, pneumopericardium is typically present with dyspnea and precordial chest pain. On physical examination, heart sounds are usually distant, and precordial tympany may be elicited. The diagnosis can be made by clinical and radiographic findings. Management of pneumopericardium depends on many factors, such as the age of the patient, the suspected causes, and the extent of clinically observed respiratory compromise. The case shown here, a patient who developed pneumopericardium, involved an associated underlying pulmonary parenchymal process as the cause of pneumopericardium.
Barotrauma ; Chest Pain ; Diagnosis ; Dyspnea ; Heart Sounds ; Humans ; Physical Examination ; Pneumopericardium*

BACKGROUND: Numerous techniques have been used to achieve long-term projection of the nipple following nipple-areola reconstruction. However, the reconstructed nipple loses projection over time. We describe a technique that uses local flaps to improve the lost projection of reconstructed nipples. METHODS: Between November 2013 and March 2015, nine patients (11 nipples) underwent revisional nipple reconstruction for lost projection. Only C-H nipple reconstructions were included in this study. The medical history of each patient was reviewed and photographs were taken in front and lateral views. All patients attended routine follow-up visits. Deepithelialized triangular flaps were made on all four sides of the nipple and buried in the opposite corners in order to augment the volume of the nipple. Anchoring sutures were used to attach each triangular flap on the side opposite their point of origin, and the resulting defects were closed directly. RESULTS: This procedure was used successfully in nine patients (11 nipples). Adequate projection was achieved in all patients and no complications occurred. The average nipple height was 3 mm before operation, 7 mm one day after operation, 5 mm at the six-month follow-up, and 5 mm at the 12-month follow-up. The average nipple-areolar angle was 164° before the operation, 111° one day after the operation, 130° at the six-month follow-up, and 133° at the 12-month follow-up. CONCLUSIONS: The method described provides a solution to the loss of projection in reconstructed nipples. We recommend this technique because it leads to better projection, greater volume, and a more natural shape.
Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Methods ; Nipples* ; Surgical Flaps ; Sutures

No abstract available.
Nitric Oxide* ; Paclitaxel* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

OBJECTIVE: To evaluate the effect of post-stroke depression (PSD) on rehabilitation outcome and to investigate the risk factors of PSD, especially, the role of caregivers type (family or professional) in subacute stroke patients. METHODS: Two hundred twenty-six stroke patients were enrolled retrospectively. All the subjects' basic characteristics, Korean version of the Beck Depression Inventory (K-BDI), Korean version of the Modified Barthel Index (K-MBI), and the modified Rankin Scale (mRS) were recorded when the patient was transferred into the Department of Rehabilitation Medicine and at the time of discharge. The results were statistically analyzed by using SPSS ver. 20.0. RESULTS: The patients' K-BDI score showed a significantly negative association with K-MBI at discharge (beta=-0.473, p<0.001) and a significantly positive association with the mRS score at discharge (beta=0.316, p<0.001). Patients with lesions on the left hemisphere (odds ratio [OR], 3.882; 95% confidence interval [CI], 1.726-8.733) and professional caregiver support (OR, 0.028; 95% CI, 0.012-0.065) had a higher rate of depression. CONCLUSION: Depression was prevalent in stroke patients, and it had a negative effect on patients' functional outcome. Patients who had a lesion on the right hemisphere had less depression. The type of caregiver was related to the incidence of subacute PSD, and family caregivers were found to lower the frequency of stroke patients' depression.
Caregivers* ; Depression* ; Humans ; Incidence ; Rehabilitation ; Retrospective Studies ; Risk Factors ; Stroke ; Treatment Outcome*

PURPOSE: We investigated the correlations between optical quality parameters obtained from the double-pass system and ocular aberrations obtained from the ray-tracing aberrometer in multifocal intraocular lens (IOL) implanted eyes. MATERIALS AND METHODS: Twenty eyes from 20 patients were enrolled in this study. Modulation transfer function cutoff frequency, The Strehl ratio, objective scatter index, and objective pseudo-accommodation obtained from the double-pass system were compared with root mean square (RMS) total aberration, RMS higher-order aberration, and spherical aberration obtained from the ray-tracing aberrometer. Additionally, parameters of the double-pass system and ray-tracing aberrometer were compared with manifested refraction values and subjective visual acuity, respectively. RESULTS: There was no statistically significant correlation between optical quality parameters obtained from the double-pass system and ocular aberrations, except between the Strehl ratio and RMS total aberration (r=-0.566, p=0.018). No significant correlations were found between the parameters of both devices, and manifested refraction values or subjective visual acuity. CONCLUSION: Optical quality parameters, especially the Strehl ratio, in multifocal IOL implanted eyes were affected by RMS total aberration. Further studies based on accurate measurements of ocular aberrations and additional optical quality parameters are needed to delineate relationships between optical quality parameters and ocular aberrations in multifocal IOL implanted eyes.
Adult ; Aged ; Cataract Extraction ; Female ; Humans ; Lens Implantation, Intraocular ; *Lenses, Intraocular ; Male ; Middle Aged ; *Refraction, Ocular ; *Visual Acuity